Provider Demographics
NPI:1073395976
Name:HOUGHTON, BENJAMIN KIMBALL (LMSW)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KIMBALL
Last Name:HOUGHTON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 SHADOW CREEK PKWY APT 1308
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7354
Mailing Address - Country:US
Mailing Address - Phone:801-200-4002
Mailing Address - Fax:
Practice Address - Street 1:12400 SHADOW CREEK PKWY APT 1308
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7354
Practice Address - Country:US
Practice Address - Phone:801-200-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111569104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker